Gentrification is Making Us Sick

Envisioning Healthy Development without DisplacementBy Zoë Levitt

The Alameda County Public Health Department (ACPHD) has witnessed the health consequences of gentrification for years. As Oakland neighborhoods have become less affordable and housing resources have decreased, the health threats have increased for the county’s most vulnerable residents. Case managers in ACPHD’s home visiting programs have heard numerous stories of low-income clients being threatened with eviction if they complain about housing conditions that contribute to asthma and other health issues.[1] Many of our clients have been forced into areas where services are less accessible and still others have been pushed into homelessness—a devastating scenario for health.

Gentrification and displacement have also come up repeatedly in the work of Place Matters, a community-centered local policy initiative of ACPHD.* This initiative was built on the recognition that the places where we live critically shape our health. Social inequities drive health inequities,[2] and policies and institutions are largely responsible for the vastly unequal conditions faced by people based on race, income, and geography. Over the years, it has become clear that while Place Matters and our community partners were successfully engaging in housing, land use, and transportation policy to improve health, gentrification was undermining those efforts by displacing longtime residents and preventing them from benefitting from neighborhood and city-level policy change.

Gentrification is the profit-driven race and class remake of urban, working class communities and communities of color that have suffered from a history of disinvestment and abandonment. This process is driven by private developers, landlords, businesses and corporations and supported by the state.[14]

Displacement is the out-migration of low-income people and people of color from their existing homes and neighborhoods due to social, economic, physical, or environmental conditions that make their neighborhoods uninhabitable or unaffordable.[15]
—Definitions from CJJC’s report Development without Displacement

CJJC and ACPHD: The Power of Partnership
When Causa Justa::Just Cause (CJJC) approached Place Matters in 2012 to work on a report about development without displacement, it was a perfect opportunity to deepen our understanding of the causes and consequences of gentrification as well as the role of public health in responding to the crisis. Our organizations had built a strong partnership, starting with a joint effort to prevent water shut-offs in foreclosed homes in 2006 and leading to our ongoing work to improve tenant protections and code enforcement practices in Oakland. We had also co-authored a report on the public health impacts of foreclosure in 2010.
Our extended partnership taught us what was possible when we pooled our different powers. CJJC has people power, organizing strategy, and a deep political analysis of the housing crisis developed through years of resident and community organizing on the ground. ACPHD can bring public health data, access to technical resources, and institutional credibility to reach and convene a broad audience. Together, we could build stronger evidence and advance more effective policy campaigns.

When CJJC released their report, Development without Displacement: Resisting Gentrification in the Bay Area last spring, a number of reporters focused on the public health angle of the story. Through a year-long partnership between CJJC and Place Matters involving resident interviews, local data, and research, we had learned that gentrification has serious impacts on the health and well-being of longtime residents of gentrifying neighborhoods, individuals and families displaced, and eventually, on our broader society.[3] Some of these impacts include:

Rising rents cost fixed income and elderly residents over 50 percent of their income and force them into difficult budget trade-offs, such as paying for electricity but not heat.[4] Gentrification can cause overcrowding, increase tenant harassment and eviction, and exacerbate discrimination in the housing market. It can also lead to closures of vital community-serving businesses and institutions.

Foreclosures combined with gentrification have deeply affected black wealth and wellbeing. Between 1990 and 2011, Oakland’s black population decreased from 43 percent to 26 percent, the largest drop by far of any group. During the same period, more than 2,000 black households were displaced from North Oakland, while homeownership, a significant wealth-building opportunity, dropped and renters grew among the city’s black population.[5] Income and wealth are among the strongest determinants of health, as they enable access to multiple health-promoting resources and opportunities, which accumulate over generations.

Displacement is financially burdensome and psychologically taxing, particularly on the poor and elderly. Moving at any age reduces social supports and increases stressors, but the longer one has lived in a neighborhood, the more likely one is to experience anxiety or depression after a move, hence elderly residents are at greatest risk of social isolation and depression due to displacement.

Displacement disrupts access to education, employment, health care, and healthy neighborhood amenities. Residents forced to move may face longer commutes to work or school, leading to increased stress, loss of income, job loss or greater school dropout rate. Displaced residents may have trouble obtaining medical records, prescriptions, and affordable health care services. Displacement can also mean relocation to neighborhoods with fewer health-promoting resources, such as high quality jobs, healthy food options, accessible public transit, and safe and walkable streets.

Displacement fractures the social and economic supports that can save lives. In CJJC’s report, the case of the elderly resident saved from a diabetic coma by a neighbor who shared coffee with her on a daily basis[6] is a clear example of the neighborhood relationships and rituals that are disrupted by displacement and critically important to health. Displacement can also mean loss of political voice, as residents lose their ability to shape the future of the city from the place where they socialize, work, or pray. Gentrification is latest among a string of urban policies causing “serial displacement”[7] of communities of color through disinvestment and disruption. This repeated upheaval and dispossession in the name of development has profoundly undermined the support systems needed to survive and thrive and impacted health and wellbeing across generations.

Displacement also harms society as a whole by increasing metropolitan segregation and inequality, which contributes to poorer health outcomes for all. As urban residents are forced into neighborhoods with less accessible public transit, displacement may also increase driving and greenhouse gas emissions for the whole region.

Gentrification: Not the Same As Development
In their report, CJJC points out that development is the investment of resources, services, and infrastructure—something all neighborhoods and communities deserve but for decades has been denied to many based on the race and class of their residents. Whereas, gentrification is the profit-driven transformation of working class communities and communities of color that have suffered from a history of disinvestment and abandonment.[8] It’s not inevitable, but a result of decades of government policy and practice, which give private developers and incoming affluent residents more resources and political voice than longtime residents, compounded by policy shifts that have massively eroded funding for affordable housing and diminished the ability of public institutions to protect and provide for our most vulnerable residents.

In order to truly prevent gentrification and displacement, a new approach to development is needed, and public health departments have a role to play in this shift.

Reimagining Healthy Development without Displacement
Public health departments have long worked in partnership with other public agencies to initiate neighborhood change in the name of health. While many of these changes have been positive, too often government-supported neighborhood change has excluded and displaced existing residents. Public health departments have a history of involvement in destructive policies like Urban Renewal, which displaced thousands of black residents and businesses from urban centers in the name of “blight removal.”[9] Our historic role in this racialized period of mass displacement demands that we make displacement prevention central to current work to build healthier communities—including partnerships between urban planners and public health to increase opportunities for physical activity, public transit access, healthy food access, and safe and walkable streets. Otherwise, these efforts may simply reproduce the unjust patterns of the past. As Dr. Muntu Davis, County Health Officer and Director of ACPHD, stated in an interview last summer: “Preventing displacement may be the single greatest challenge and the most important task in our efforts to create healthy communities for all.”[10]

There is much work to be done to realize healthy development and public agencies cannot and should not do it alone. Community organizations, advocates, and residents throughout the Bay Area have advanced a powerful movement for development without displacement and secured a number of exciting victories in recent months.

Impacts of Gentrification and Displacement
At a recent discussion hosted by CJJC and Place Matters, a County employee and lifelong Oakland resident illustrated the unhealthy and unjust consequences of gentrification with this personal story: As a young person growing up in West Oakland, he and his friends wrote repeatedly to City Hall requesting improvements to a park where they played basketball but to no avail. It was only decades later that the City initiated major landscaping and improvements to that park—alongside the introduction of several market rate housing developments, the influx of whiter, wealthier, and more politically connected residents, and rising rents. When residents who have lived, worked, and contributed to their neighborhoods for decades in the face of disinvestment aren’t able to stay and benefit from change, such development is neither healthy nor sustainable.
At a Baptist church in West Oakland recently I learned that 60 to 70 percent of the congregants had been displaced to other cities around the Bay, which meant that they could not vote in their city of worship, even though many of them would have liked to support increasing Oakland’s minimum wage.

CJJC and the Tenant Justice Campaign secured improvements to Oakland’s rent regulations last spring, and more recently, won the adoption of the Tenant Protection Ordinance, which will protect thousands of tenants from landlord harassment, a common cause of displacement. Together, these represent the only legislative advances for tenants’ rights in Oakland for over a decade. Other promising actions underway include a community-based planning partnership to create “Healthy Development Guidelines” for Oakland—a joint effort between East Oakland Building Healthy Communities,[11] (under the leadership of Communities for a Better Environment, CJJC, East Bay Housing Organizations, and HOPE Collaborative), ACPHD, and the City of Oakland Planning Department, with technical assistance from ChangeLab Solutions. This multi-year resident engagement process will result in a tool that city planners can use to ensure that new development meets community-identified priorities for health equity. Many other exciting efforts are happening across the region. In both Contra Costa and San Mateo Counties, local health departments are raising displacement as a health issue, supporting anti-displacement community organizing, and providing policy and technical support to cities facing displacement pressure.

Public health departments and community organizations can and should strive to be allies in community-led struggles for development without displacement. To support these efforts, public health departments can provide public health data, research, and analysis to document the significance of displacement and the health consequences it brings. This means addressing all the reasons residents are forced to move—including lack of opportunity, habitability, and affordability. We can also provide testimony at public meetings and convene institutional and community partners to advance needed policy change such as tenant protections and affordable housing preservation, among other solutions.[12] Ultimately, our healthy development efforts should focus on ensuring that existing residents have the voice, opportunities, and resources they need to shape and be healthy and thrive in the places and communities they already call home.

As Maria Poblet, executive director of CJJC, stated in a recent blog post: “The struggle for stable, habitable homes needs to be a collective one; a people-powered process that shows us our power as creators of community instead of as consumers; a process that city officials accompany us in as allies of the people they represent; a process that builds grassroots institutions through which we build long-term progressive political power and grow in community with each other in the city we call home.”13 In this collective struggle, the task of public health departments is to see our role as allies of the people and use our institutional powers to protect health and wellbeing for all—including the right to stable, affordable, and healthy homes and neighborhoods.

The information presented in this article represents the ideas, hard work, and expertise of many Alameda County Public Health Department staff, partners, and community members, especially the staff and members of CJJC. Special thanks to editors and thought partners, including Katherine Schaff, Tram Nguyen, Robbie Clark, Anna Lee, Kimi Watkins-Tartt, Dawn Phillips, Alex Desautels, and Will Dominie. CJJC’s report, Development without Displacement is available at www.cjjc.org. For more information on Place Matters: www.acphd.org/social-and-health-equity/policy-change/place-matters.aspx

Zoë Levitt is Local Policy Associate at the Place Matters Initiative of the Alameda County Public Health Department.

Endnotes* In 2006, at the invitation of the national Place Matters Initiative, now part of the National Collaborative for Health Equity, Alameda County Supervisor Keith Carson’s office and ACPHD launched Alameda County Place Matters. This initiative is dedicated to working in partnership with community organizations and residents to advance local policy change in the areas of housing, economics, education, criminal justice, land use, and transportation.
1. Public Testimony, Amy Scholinbeck. Oct 14, 2014. Oakland City Council Meeting.
2. Whitehead M, Povall S, Loring B. (2014). The Equity Action Spectrum: Taking a Comprehensive Approach. World Health Organization. Available at: www.euro.who.int/__data/assets/pdf_file/0005/247631/equity-action-090514.pdf.
3. For a full discussion of health impacts and sources consulted, see Causa Justa::Just Cause, Development without Displacement, page 41. Available at: http://cjjc.org/images/development-without-displacement.pdf.
4. Ibid, page 43.
5. Alameda County Public Health Department with data from Census 1990, Census 2000, and American Community Survey 2007-2011.
6. CJJC, page 43.
7. Fullilove, M.T. & Wallace R. (2011). “Serial Forced Displacement in American Cities: 1916-2010.” Journal of Urban Health, 88(3):381-389.
8. CJJC, page 8, for a full definition and analysis of gentrification.
9. Lopez, R.P. (2009). “Public health, the APHA, and urban renewal.” American Journal of Public Health, 99(9): 1603–1611.
10. Rivas J. “New Study: Being Gentrified is Bad for Your Health.” www.fusion.net. April 7, 2014.
11. For more information about East Oakland Building Healthy Communities, see www.eobhc.com.
12. For a full list of policy recommendations, see CJJC, Development Without Displacement, page 59.
13. Poblet, Maria. “The Struggle for the Flatlands: How Oakland Can Fight Gentrification.” www.cjjc.org. April 22, 2014.
14. CJJC, page 8, for a full definition and analysis of gentrification.
15. Ibid

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